Spontaneous Regression Of Allergic Bronchopulmonary Mycosis Due To Curvularia Lunata
Nasu, S., Satoh, S., Shimizu, K., Matsuno, O., Morishita, H., Yaguchi, T., Kawahara, K., & Matsuoka, H. (2018). Spontaneous Regression of Allergic Bronchopulmonary Mycosis Due to Curvularia lunata. Internal medicine (Tokyo, Japan), 57(2), 243–246. https://doi.org/10.2169/internalmedicine.8771-16
View Original Source →Abstract
Allergic bronchopulmonary mycosis (ABPM) is a pulmonary hypersensitivity disease mainly caused by Aspergillus fumigatus. The mainstay treatment for ABPM is systemic corticosteroid therapy. A 25-year-old man presented with pulmonary infiltrates. His peripheral eosinophil, total serum IgE, and serum Aspergillus-specific IgE levels were elevated. The patient tested positive in a skin test for Aspergillus. However, sputum cultures revealed a Curvularia lunata infection. We therefore diagnosed ABPM possibly caused by C. lunata, which is rare in Japan. The clinical state of the patient improved under observation. Identification of the causative fungus is an important aspect of the ABPM diagnosis.
Case Details
Disease Location
2nd degree bronchi
Personal Characteristics
25-year-old man
Clinical Characteristics
Admitted with a productive cough that had persisted for 4 months. The patient occasionally expectorated brown plugs and had a history of bronchial asthma since childhood, and asthma symptoms approximately once a year following an upper respiratory tract infection. Chest x-ray images acquired upon admission at our hospital revealed infiltration in the right upper lung field. High-resolution chest computed tomography (CT) images revealed central bronchiectasis, with a mucus plug in the right upper lobe. Results of laboratory tests showed elevated blood eosinophil and serum ige levels. His serum aspergillus-specific ige levels were elevated, and the skin prick test with aspergillus antigen revealed positive results. Bronchoscopy was performed. A yellow mucus plug, recognized in the right bronchus, was submitted for smear test, fungal culture, and pathological examination. Histological findings revealed a large population of mold in the mucus, along with eosinophils. Microscopic evaluation revealed dematiaceous fungi with conidia containing four cells. Based on the morphological and phylogenetic findings, the fungus was identified to be c. Lunata
Remission Characteristics
After 9 months without systemic corticosteroid or antifun- gal therapy, the patient exhibited an improvement in his symptoms, laboratory diagnostic features, and imaging findings